2018 2019 Employee Health Benefits - Insurance Summary Booklet - Wellness @ LBUSD
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2018 ‒ 2019
Employee Health Benefits
Insurance Summary Booklet
Long Beach Unified
School District
OFFICE OF THE SUPERINTENDENT
1515 Hughes Way, Long Beach, CA 90810-1839
www.lbschools.net
Dear Colleagues,
The health and welfare benefits our school district offers are an integral part of the total rewards package you receive in
exchange for the important work that you do. Our comprehensive health and wellness offerings support you at work and
beyond, helping you maintain and improve your family’s health. Each year, our district, in partnership with TALB and CSEA,
evaluates your benefit plans, and the vendors that offer them, to ensure we continue to provide comprehensive benefits and
choices that meet our employees’ diverse needs. That’s why we made the move to Aetna as our medical insurance carrier.
Continued Focus on Health Improvement
In addition to efficient benefits administration, Aetna was chosen because it offers enhanced personalized services for
our members to help achieve better health outcomes. Some of the services included with your Aetna health plan are
described below.
Simple Steps provides digital coaching programs, all online — all personalized to your health goals — whether you’re
managing a health risk, overcoming an old habit, or just eating healthier.
In Touch Care for members with acute and chronic needs, provides:
•• One-on-one phone calls with a nurse who serves as a trusted resource for you and your family
•• Digital support that provides a variety of resources to help you better manage your health
•• Customized health action plans based on your needs and preferences
Personal Health Record is an online home for your health information that can:
•• Help provide better, safer and more cost-effective care
•• Scan the information in your personal health record and compare it to thousands of the latest medical guidelines
•• Spot potential medical problems, possible drug interactions or gaps in care, and post a message to you. The doctor treating
you will also get an alert if it’s urgent.
Concierge helps you make sense of the big and complex world of health care by:
•• Walking you through tools to help you make great decisions
•• Finding network providers based on your medical needs
•• Helping you schedule appointments to save you some stress
In addition to these Aetna health services, we continue to partner with Weight Watchers to help you maintain healthy habits.
Enroll through the LBUSD Weight Watchers program to get more than 50% off the cost of membership. Benefit-eligible
spouses and medical plan-enrolled retirees and retiree spouses are also eligible for discounted membership.
Visit www.lbusdwellness.com for more information on Aetna and their programs and read monthly updates from our
district and Weight Watchers.
Best wishes for continued good health and success here in the Long Beach Unified School District.
Sincerely,
Christopher J. Steinhauser
Our Mission:
To support the personal and intellectual success of every student, every day.
Our Vision:
Every student a responsible, productive citizen in a diverse and competitive world.
1
1
What’s Inside
This booklet includes important details
about your District benefits, including
which benefits you can enroll your
eligible dependents in, details about
your plans, and the steps you need to
take to enroll. You’ll also find information
about how and when to enroll.
We encourage you to keep this booklet
for your reference throughout the year. If
you still have questions after reviewing
the booklet, feel free to contact the
Employee Service Center. You can find
important notices about state and
federal laws that affect your benefits
on our LBUSD Benefit website at
www.lbusdwellness.com.
The Employee Service Center
The District’s Employee Service
Center is ready to help if you have
any benefits-related questions. Need
detailed information about your
medical benefits? Want to know if your
dependent is eligible for coverage?
Have a question about enrollment?
Just give the Employee Service Center
a call at (866) 844-9744, option 4.
Representatives are available Monday
through Friday from 5 a.m. to 5 p.m.,
Pacific time.
2
Table of Contents
Benefits Eligibility 4
Employee Eligibility 4
Dependent Eligibility 4–5
Your Cost for Benefits 5
When to Enroll 6
Enrolling When You're First Eligible 6
Making Changes During Open Enrollment 6
Making Changes During the Year 7
How to Enroll 8
Employee Service Center 9
An Overview of Your Benefits 10
Medical Coverage Options 10
CSEA — 2018 – 2019 Medical Coverage Options 11
NON-REPRESENTED — 2018 – 2019 Medical 12
Coverage Options
TALB — 2018 – 2019 Medical Coverage Options 13
Prescription Drug Benefits 14 – 16
Employee Assistance Program (EASE) 16
Dental Plan Options 17
Vision Coverage 18
Flexible Spending Accounts (FSAs) 19
2018 FSA Contribution Limits 19
Group Life Insurance and Group 20
Accidental Death & Dismemberment
Insurance
Life Insurance Conversion 20
Retirement Plans 21
Internal Revenue Code (IRC) Section 21
125 Flexible Fringe Benefits Plan
Important Information About Your Benefits 22
Appealing a Claim 22
Filing a Complaint or Grievance 22
Phone Numbers and Websites 23
This booklet is intended to provide highlights of your benefits only; it is not an Evidence of Coverage (EOC) plan
document. Official plan and insurance documents govern your rights and benefits under each plan. For more details
about your benefits, including a complete list of exclusions and limitations, please refer to each carrier’s EOC. The
EOCs are available on our LBUSD Benefit webiste, www.lbusdwellness.com.
3
Benefits Eligibility
Employee Eligibility
In general, you’re eligible for medical, dental, vision, and life and AD&D insurance
benefits if you’re:
•• A probationary or permanent employee; and
•• You work 50% or more of a full-time assignment (at least 80 hours every four
weeks).
Residency Requirements In addition, job share participants may enroll in District plans under certain
conditions.
Some plans have residency
If you’re a represented employee, we encourage you to review your collective
requirements. If you’re going to be
bargaining contract each year to verify your specific eligibility requirements. You
covering a dependent out of state,
may also call the Employee Service Center at (866) 844-9744, option 4, for more
please contact your plan’s member information.
services or refer to the Evidence of
Coverage for more information.
Dependent Eligibility
If you enroll yourself in District benefits, you can also enroll your eligible dependents
in certain plans (vision coverage, life insurance and AD&D insurance are available to
employees only). You must provide appropriate proof of the dependent relationship
when you enroll your dependent.
Eligible dependents include:
Important! •• Your legal spouse. (Required documentation: a marriage certificate in English.)
The District reserves the right to •• Your California-registered domestic partner. A California-registered domestic
require evidence of the disability partner is the same gender as you or may be opposite-gender only if at least
status at any time. one partner is over age 62. (Required documentation: a certified copy of the
Declaration of Domestic Partnership filed with the Secretary of State.) Please
note: Domestic partners do not receive the same tax benefits as legal spouses. You
and your domestic partner must become legal spouses to receive tax benefits.
•• Your natural children or stepchildren up to age 26.
–– Adopted children must have been placed by a recognized county or private
agency and must be in the physical control of you or your spouse or domestic
partner, and you must have the right to control the health care of the child.
(Required documentation: a birth certificate.)
4
•• Your children, stepchildren, or adopted children who are developmentally or
physically disabled. Your dependent must also:
–– Be chiefly dependent on you or your spouse or domestic partner for support and
maintenance;
–– Have been disabled continuously prior to reaching limiting age;
–– Have been enrolled as a dependent under your coverage before reaching limiting age;
and
–– The proof of disability must be submitted to the Employee Service Center within 30
days after the onset of the disability, the attainment of the limiting age, or the time
of initial enrollment. (Required documentation: a birth certificate and a physician’s
written certification of the disability.)
•• Any children for whom you are the legal, non-temporary guardian (excluding foster
children) or whom you are required to support as part of a Qualified Medical Child
Support Order (QMCSO) (Required documentation: court or administrative orders from
the District Attorneys' office, State Department of Health Services, or the courts). Children
who meet these requirements are eligible for coverage as long as they don’t have access
to medical coverage through their employer.
Your Cost for Benefits
Each year, the District will pay a maximum contribution toward medical coverage premiums
for you and your dependents. If the District’s maximum medical contribution does not
cover the full cost of the premium (based on the plan and coverage level you elected), you
will pay the remaining amount through payroll deductions. Keep in mind that the lowest
cost HMO plan will be free to eligible employees each year. The lowest cost plan may
change on an annual basis.
Each year, the District will increase the prior year’s District annual maximum contribution
toward insurance premiums by 3.5%. The rates for July 1, 2018 – June 30 , 2019 will apply to
all coverage levels: employee only, employee plus one and family, as shown below.
Your premiums for benefits can be found on the personalized worksheet you receive when
you first become eligible for District benefits. You’ll also receive a personalized worksheet
every year during the annual Open Enrollment. If you’re making changes to your benefits
outside the Open Enrollment period because of a qualifying change in status, contact the
Employee Service Center at (866) 844-9744, option 4, for your cost information.
Tier July 2018 – June 2019 July 2018 – July 2018 –
District Annual June 2019 June 2019
Maximum (DAM) Employer Costs Employee Cost
Employee $12,204 $11,950 $0.00
Employee + 1 $22,320 $21,800 $0.00
Family $28,030 $27,425 $0.00
Although the District pays the full cost of coverage for most employees, certain job share
and management employees who work less than full time may be required to pay a portion
of the premium for this benefit. If you do not want to pay these premiums, you must
elect to waive this benefit during your enrollment.
If you’re a collective bargaining employee, please refer to your collective bargaining
agreement to determine District-paid premiums. You can find the full details of the plans in
the Certificate of Insurance, which is available on our LBUSD Benefit website at
www.lbusdwellness.com.
55
When to Enroll
You’re allowed to enroll in benefits and make changes to your benefits only:
•• When you’re initially eligible;
•• During the annual Open Enrollment period; or
•• If you experience a qualifying status change.
Enrolling When You're First Eligible
You must enroll yourself and your dependents within 30 days of becoming eligible for
District benefits. You can enroll eligible dependents at the same time you enroll yourself.
If you don’t enroll, you’ll receive the default coverage shown below.
Default Coverage
If you’re eligible for 100% District-paid benefits and you don’t elect or waive coverage
within the 30-day window, you’ll automatically be enrolled as follows:
•• TALB and Non-represented employees:
––Aetna Choice POS II (Open Access) medical plan;
––Delta PPO Plus Premier dental plan;
––Vision;
––Life and accidental death & dismemberment insurance; and
––Employee Assistance Program (EASE).
•• CSEA:
––Kaiser HMO medical plan;
––DeltaCare DHMO dental plan;
––Vision;
––Life and accidental death & dismemberment insurance; and
––Employee Assistance Program (EASE).
Your dependents will not be covered under default coverage.
Making Changes During Open Enrollment
Once you’ve enrolled in benefits, you generally aren’t allowed to make changes until
the next Open Enrollment. Open Enrollment is your one chance each year to review
your coverage and make changes to your benefits. It's also your chance to enroll if you
declined coverage when you first became eligible.
The elections you make during Open Enrollment will take effect on July 1 and be
effective through June 30 of the following year. Open Enrollment will occur each spring,
generally in May.
Please note, Flexible Spending Accounts (FSAs) are now part of the regular plan year
and are effective July 1 – June 30 each year. If you don’t use your whole balance by
June 30, 2019, you’ll have a grace period to use the funds and submit claims. If you don’t
use your balance by September 15, 2019 and submit claims by September 28, 2019
you’ll forfeit any remaining funds.
6 6
Making Changes During the Year
Other than during Open Enrollment, you can make changes to your benefits during the
year only if you experience a qualifying status change. Any changes must be made within
30 days of the qualifying status change. A qualifying status change can include:
•• A change in family status, such as your marriage or registration of a domestic
partnership, the birth or adoption of a child, divorce or dissolution of a domestic
partnership, or the death of a dependent. You must provide the Employee Service Center
with proof of the event (such as a marriage certificate, birth certificate, divorce order, or
court order).
•• The loss of existing coverage for you and/or your eligible dependents (for example, the
termination of coverage that was provided through your spouse’s employer).
•• A qualified court or administrative order that requires you to provide coverage for an
eligible dependent.
Any benefit changes must be consistent with the qualifying status change. Provided you
make changes within 30 days of the event, the change will take effect on the date of the
event for a birth, adoption, or placement for adoption; changes you make as a result of
other qualifying status changes will take effect the first day of the month after the event.
You must submit the appropriate documentation to the Employee Service Center.
Notice of Special Enrollment Rights for Medical Plan Coverage
If you’ve declined enrollment in a District medical plan for yourself or your dependents
(including your spouse or same-sex domestic partner) because of other medical plan
coverages, you and/or your dependents may be able to enroll in a District medical plan
without waiting for the next Open Enrollment period, provided that you request enrollment
within 30 days after your other coverage ends. In addition, if you have a new dependent as
a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll
yourself and your dependents, provided that you request enrollment within 30 days after
the marriage, birth, adoption, or placement for adoption.
The District will also recognize and allow a special enrollment opportunity in a medical plan
if you or your eligible dependents:
•• Lose Medicaid or Children’s Health Insurance Program (CHIP) coverage because you’re no
longer eligible; or
•• Become eligible for a state’s premium assistance program under Medicaid or CHIP.
For these new enrollment opportunities only, you’ll have 60 days — instead of 30 — from the
date of the Medicaid/CHIP eligibility change to request enrollment in a District medical plan.
For more information or to request a special enrollment after a qualifying status change,
contact the Employee Service Center at (866) 844-9744, option 4.
77
How to Enroll
Make Sure You’re Once you’ve decided which benefits you’d like, the easiest way to enroll is through
Up-to-Date! the District’s online enrollment site, www.lbusdbenefits.com.
If you use the online enrollment When you enroll online, you’ll be able to review your benefit elections and make
system, make sure you’re using sure your dependent information is correct. The online enrollment site also has all
a recent version of your web the details about each plan, right at your fingertips.
browser; you may have problems
if you’re using an older version
of Internet Explorer or an older Here are the steps to take to click your way through online enrollment:
Macintosh browser.
1 Go to www.lbusdbenefits.com.
2 Log-in to the site. Your user ID is the last six digits of your Social
Security number, and the first time you Log-in, your password is
your date of birth in MMDDYYYY format. (For example, if you were
Steps to Upload Your born May 9, 1970, your password would be 05091970.)
Benefit Documents
3 After you log-in to the site for the first time, you’ll be prompted to
Online
change your password.
1. Save the documentation to a
file on your computer in .pdf 4 Click “Enrollment” under the “Steps to Enroll” heading.
format
5 You can review your current benefits by selecting “Review
2. Login to Employee Coverage.”
www.lbusdbenefits.com
3. Enter your login information 6 To enroll for your benefits, select “Open Enrollment” at the top of
– Your login is your unique
the page.
user name and the password 7 For each benefit, select the plan and coverage level you want, then
you created
click “Next” to move to the next benefit.
4. Select the 'Upload Document'
tab on the blue tool bar 8 Once you’ve completed the enrollment process, you’ll be directed
5. Select 'Upload' to a confirmation page, at which point you can print a confirmation
statement. You’ll also receive a paper confirmation statement in the
6. Select 'Browse'
mail once your enrollment is complete.
7. Locate the saved
documentation on your
computer and select 'Open'
8. Select 'Save'
To view what documents have
Before You Enroll!
been uploaded, click the 'Upload Before you begin enrollment, make sure you have:
Document' link • Your dependent's Social Security numbers; and
• Y
our primary care provider’s (PCP’s) name and PCP ID, if you’re enrolling in
the Aetna HMO plan and/or the DeltaCare DHMO dental plan. (If you don’t
provide a PCP ID, you’ll automatically be assigned a PCP.)
Once you enroll, you’ll also be required to send the Employee Service Center
the required documentation for your newly added dependents.
8 8
Employee Service Center
In addition to using the online enrollment system, you may enroll through the Employee
Service Center. Speak with an Employee Service Center representative by calling (866) 844-9744,
option 4. (Employee Service Center representatives are available Monday through Friday
from 5 a.m. to 5 p.m., Pacific time.)
Waiving Coverage
When you enroll online, you may choose to waive, or decline, enrollment in one or
more benefit plans by selecting the “Waive” button. Keep in mind that if you choose
to waive coverage, it means that you are declining coverage from July 1, 2018 through
June 30, 2019. It DOES NOT mean that you will continue with the same coverage you
currently have. If you waive coverage during this enrollment, you will not be able to
re-enroll for coverage during this period unless you experience a qualifying status
change. If you elect to waive health coverage, you will be required to complete and
sign a waiver form. If this form is not completed within 30 days, you only (and not
your dependents) will be placed in the default coverage.
NOTE: Your Enrollment communication contains a worksheet that you can use to plan
your elections. Do not submit this form to the Employee Service Center or Risk
Management.
99An Overview of Your Benefits
The District offers you and your eligible dependents a comprehensive selection of health care and financial benefits.
Health Care Benefits
Medical The District offers two HMO Plans:
• Kaiser Permanente HMO
• Aetna HMO
The District also offers the following plans:
• Aetna Choice POS II (Open Access)
• Aetna Choice POS II (Open Access) HDHP (for Non-represented employees)
All medical plans include prescription drug coverage. A summary of these benefits is provided on
pages 11 – 16.
Dental The District offers two dental plans:
• Delta PPO Plus Premier
• Delta Care DHMO
You can find a summary of your dental benefits on page 17.
Vision The Medical Eye Services (MES) vision plan is available to employees only. More information about
this plan is available on page 18.
Employee Assistance Program The District provides EASE to assist employees with personal and work/life issues. You can find
(EASE) additional information about EASE on page 16.
Financial Savings & Security
Flexible Spending Accounts (FSAs) FSAs give you the option to set aside pre-tax funds to pay for certain eligible health care and
dependent care expenses. You can find more details about FSAs on page 19.
Group Life and Group Accidental The District provides eligible employees with life and AD&D insurance coverage to help provide
Death & Dismemberment (AD&D) financial protection. More details about these coverages are available on page 20.
Insurance
Deferred Compensation (IRC 457) So you can set aside pre-tax money for retirement, the District offers you the opportunity to
Retirement Plan participate in a Deferred Compensation Plan. Details about this plan can be found on page 21.
IRC Section 125 Flexible Fringe This plan allows you to pay premiums for certain District benefits and potentially reduce your
Benefits Plan taxes at the same time. Details about this plan can be found on page 21.
Medical Coverage Options
Teladoc — A Great
Your medical benefits are designed to help maintain the wellness and health of you and your
Resource for Aetna
family. The District offers three types of medical plan options.
Members
•• HMO Plans: With the HMO options, you must receive care from providers in the plan’s
If you are a Aetna member, you
network; the plan won’t pay any benefits for care received outside the network except in an
will have access to telemedicine
emergency.
services through your District
medical benefits. These programs •• C
hoice POS II (Open Access) Plan: With this plan, you have the flexibility to receive care from
give you 24/7/365 access to a doctor any provider; however, the plan will pay a higher level of benefits when you receive care from
through the convenience of your a provider who participates in the plan’s network.
smartphone, tablet, or computer. •• C
hoice POS II (Open Access) HDHP Plan: With this plan, you have the coverage of a POS
You can connect with doctors using plan, and can establish an account that allows you to save for health care expenses tax-free
the video chat function on your (known as a Health Savings Account, or HSA). More information about the HSA is available at
computer, smartphone or tablet, www.lbusdbenefits.com.
or you can speak with a provider Keep in mind that certain benefits in each plan may vary, depending on your bargaining unit.
over the phone. Doctors can assess For employees represented by CSEA, a summary of your benefits is provided on page 11.
and diagnose conditions such as Employees represented by TALB can find a summary of their benefits on page 13, while a
bronchitis and even fill prescriptions summary of the benefits for Non-represented employees can be found on page 12.
(depending on your location) during
your digital consultation. It's an
affordable option for quality medical
care. Call (855) 835-2362.
10 10CSEA — 2018 – 2019 Medical Coverage Options
This chart is intended to provide highlights of your benefits only; it is not an Evidence of Coverage (EOC) plan document. Official plan
and insurance documents govern your rights and benefits under each plan. For more details about your benefits, including a complete
list of exclusions and limitations, please refer to each carrier’s EOC.
Aetna Choice POS II
Kaiser HMO1 Aetna HMO1
In-Network Out-of-Network
Plan Year Deductible
None None $300/$600 $500/$1,000
Individual/Family
Plan Year Out-of-Pocket Maximum
(including deductible) $1,500/$3,000 $250/$500 $1,300/$2,600 $5,500/$11,000
Individual/Family
Lifetime Maximum Unlimited Unlimited Unlimited
Member Cost for Covered Services
Inpatient Hospital No charge No charge 20% 40%
Outpatient Surgery $10 copay No charge 20% 40%
Ambulatory Surgery Center
$10 copay No charge 20% 40%
and Outpatient Services
$100 copay $100 copay
$100 copay $100 copay
Emergency Room Facility (waived if (waived if
(waived if admitted) (waived if admitted)
admitted)2 admitted)
Emergency Room Physician No charge No charge 20% after deductible 20% after deductible
Physician Office Visit $10 copay $10 copay 20% 40%
Routine Physical No charge No charge No charge3 40%
Well-Baby & Well-Child Care No charge No charge No charge3 40%
Well-Woman Exams No charge No charge No charge3 40%
Maternity Care No charge No charge No charge3 40%
Lab and X-ray No charge No charge 20% 40%
Physical or Occupational Therapy $10 copay $10 copay 20% 40%
$5 copay $5 copay
Chiropractic Care (Up to 30 visits/ (Up to 30 visits/ 20% 40%
year) year)
Durable Medical Equipment No charge No charge 20% 40%
Mental Health
Inpatient No charge No charge 20% 40%
Outpatient $10 copay $10 copay 20% 40%
Prescription Drugs4 Kaiser Aetna Express Scripts
Out-of-Pocket Maximum Combined with
None $5,550/$11,100
Individual/Family medical
Retail 100 day supply 30 day supply 30 day supply6
Generic: $5 copay Generic: $5 copay Generic: $5 copay
Brand: $10 copay Brand: $10 copay Brand: $20 copay
Non-formulary: Non-formulary: Non-formulary: $50 copay
$10 copay5 $35 copay
Not covered
Mail Order 100 day supply 90 day supply 90 day supply
Generic: $5 copay Generic: $5 copay Generic: $0 copay
Brand: $10 copay Brand: $10 copay Brand: $20 copay
Non-formulary: Non-formulary: Non-formulary: $50 copay
$10 copay5 $35 copay
1 If you enroll in an HMO plan, you can obtain services only within the plan’s geographic service area, except for urgent and emergency services.
2 The Emergency Room Copay does apply if you are admitted for observation but are not admitted as an inpatient.
3 Preventive care is 100% covered in-network with no deductible required. Routine tests and screenings are free to you when you use in-network providers, too.
4 Some contraceptive prescriptions for women are 100% covered in-network with no copay or deductible required. Age limits may apply. Contact the plan for details.
5 For Kaiser plans, non-formulary brand-name drugs are not listed on the drug formulary and aren't covered unless approved through an exception
process initiated by the members plan physician. If approved, non-preferred (non formulary) brand-name drugs are covered at the brand copay.
6 Diabetic medications are available in 90 day supplies at select retail pharmacies.
If you don’t enroll for coverage when you’re first eligible, you’ll be automatically enrolled in the CSEA default coverage for yourself only: Kaiser HMO medical plan, DeltaCare 11
DHMO dental plan, vision coverage, life and accidental death & dismemberment insurance, and the employee assistance program.NON-REPRESENTED — 2018 – 2019 Medical Coverage Options
This chart is intended to provide highlights of your benefits only; it is not an Evidence of Coverage (EOC) plan document. Official plan and
insurance documents govern your rights and benefits under each plan. For more details about your benefits, including a complete
list of exclusions and limitations, please refer to each carrier’s EOC.
Aetna Choice POS II Aetna Choice POS II HDHP
Kaiser HMO1 Aetna HMO1 In-Network Out-of-Network In-Network Out-of-Network
$1,500/$3,000 (For family coverage, full
Plan Year Deductible
None None $300/$600 $500/$1,000 family deductible must be met before plan
Individual/Family
pays benefits)
Plan Year Out-of-Pocket $3,275/$6,550 (For family coverage, full
$1,300/
(includes deductible) $1,500/$3,000 $250/$500 $5,500/$11,000 family out-of-pocket maximum must be
$2,600
Maximum Individual/Family met before plan pays benefits)
Lifetime Maximum Unlimited Unlimited Unlimited Unlimited
Health Savings Account (HSA) None None None Available (includes District contribution)
Member Cost for Covered Services
Inpatient Hospital No charge No charge 20% 40% 10% 40%
Outpatient Surgery $10 copay No charge 20% 40% 10% 40%
Ambulatory Surgery Center
$10 copay No charge 20% 40% 10% 40%
and Outpatient Services
$100 copay $100 copay (waived
$100 copay (waived $100 copay (waived $100 copay (waived if $100 copay (waived if
Emergency Room Facility (waived if if admitted), then
if admitted)2 if admitted) admitted) admitted), then 10%
admitted) 10%
20% after
Emergency Room Physician No charge No charge 20% after deductible 10% after deductible 10% after deductible
deductible
Physician Office Visit $10 copay $10 copay 20% 40% 10% 40%
Routine Physical No charge No charge No charge3 40% No charge3 Not covered
Well-Baby & Well-Child Care No charge No charge No charge3 40% No charge3 Not covered
Well-Woman Exams No charge No charge No charge3 40% No charge3 Not covered
Maternity Care No charge No charge No charge3 40% No charge3 40%
$25 then you
Lab and X-ray No charge No charge 20% 40% 40%
pay 10%
Physical or
$10 copay $10 copay 20% 40% No charge 40%
Occupational Therapy
$5 copay (Up to $5 copay (Up to 10% (Up to 40% (Up to
Chiropractic Care 20% 40%
30 visits/year) 30 visits/year) 20 visits/year) 20 visits/year)
Durable Medical Equipment No charge No charge 20% 40% 10% 40%
Mental Health
Inpatient No charge No charge 20% 40% 10% 40%
Outpatient $10 copay $10 copay 20% 40% 10% 40%
Prescription Drugs4 Kaiser Aetna Express Scripts Aetna5
Out-of-Pocket Maximum Combined with
None $5,550/$11,100 Combined with medical
Individual/Family medical
Retail 100 day supply 30 day supply 30 day supply7 30 day supply
Generic: $5 copay Generic: $5 copay Generic: $5 copay Generic: $5 copay
Brand: $10 copay Brand: $10 copay Brand: $20 copay Brand: $10 copay
Non-formulary: Non-formulary: Non-formulary: Non-formulary:
$10 copay7 $35 copay $50 copay $35 copay
Not covered Not covered
Mail Order 100 day supply 90 day supply 90 day supply 90 day supply
Generic: $5 copay Generic: $5 copay Generic: $0 copay Generic: $5 copay
Brand: $10 copay Brand: $10 copay Brand: $20 copay Brand: $10 copay
Non-formulary: Non-formulary: Non-formulary: Non-formulary:
$10 copay6 $35 copay $50 copay $35 copay
1 If you enroll in an HMO plan, you can obtain services only within the plan’s geographic service area, except for urgent and emergency services.
2 The Emergency Room Copay does apply if you are admitted for observation but are not admitted as an inpatient.
3 Preventive care is 100% covered in-network with no deductible required. Routine tests and screenings are free to you when you use in-network providers, too.
4 Some contraceptive prescriptions for women are 100% covered in-netwºrk with no copay or deductible required. Age limits may apply. Contact the plan for details.
5 For the Choice POS II HDHP, prescription drugs count towards annual deductible.
6 For Kaiser plans, non-formulary brand-name drugs are not listed on the drug formulary and aren't covered unless approved through an exception process initiated by the
members plan physician. If approved, non-preferred (non formulary) brand-name drugs are covered at the brand copay.
7D
iabetic medications are available in 90 day supplies at select retail pharmacies.
If you don’t enroll for coverage when you’re first eligible, you’ll be automatically enrolled in the non-represented default coverage for yourself only: Aetna Choice POS II medical plan,
Delta PPO Plus Premier plan, vision coverage, life and accidental death & dismemberment insurance, and the employee assistance program.
12 12TALB — 2018 – 2019 Medical Coverage Options
This chart is intended to provide highlights of your benefits only; it is not an Evidence of Coverage (EOC) plan document. Official
plan and insurance documents govern your rights and benefits under each plan. For more details about your benefits, including a
complete list of exclusions and limitations, please refer to each carrier’s EOC.
Aetna Choice POS II
Kaiser HMO1 Aetna HMO1
In-Network Out-of-Network
Plan Year Deductible
Individual/Family None None $300/$600 $500/$1,000
Plan Year Out-of-Pocket
Maximum (includes deductible) $1,500/$3,000 $250/$500 $1,300/$2,600 $5,500/$11,000
Individual/Family
Lifetime Maximum Unlimited Unlimited Unlimited
Member Cost for Covered Services
Inpatient Hospital No charge No charge 20% 40%
Outpatient Surgery $10 copay No charge 20% 40%
Ambulatory Surgery Center
$10 copay No charge 20% 40%
and Outpatient Services
$100 copay $100 copay $100 copay $100 copay
Emergency Room Facility
(waived if admitted)2 (waived if admitted) (waived if admitted) (waived if admitted)
Emergency Room Physician 20% after deductible 20% after deductible
Physician Office Visit $10 copay $10 copay 20% 40%
Routine Physical No charge No charge No charge3 40%
Well-Baby & Well-Child Care No charge No charge No charge3 40%
Well-Woman Exams No charge No charge No charge3 40%
Maternity Care No charge No charge No charge3 40%
Lab and X-ray No charge No charge 20% 40%
Physical or Occupational Therapy $10 copay $10 copay 20% 40%
$5 copay $5 copay
Chiropractic Care 20% 40%
(Up to 30 visits/year) (Up to 30 visits/year)
Durable Medical Equipment No charge No charge 20% 40%
Mental Health
Inpatient No charge No charge 20% 40%
Outpatient $10 copay $10 copay 20% 40%
Prescription Drugs4 Kaiser Aetna Express Scripts
Out-of-Pocket Maximum
None Combined with medical $5,550/$11,100
Individual/Family
Retail 100 day supply 30 day supply 30 day supply6
Generic: $5 copay Generic: $5 copay Generic: $5 copay
Brand: $10 copay Brand: $10 copay Brand: $20 copay
Non-formulary: $10 copay5 Non-formulary: Non-formulary: $50 copay
$35 copay
Not covered
Mail Order 100 day supply 90 day supply 90 day supply
Generic: $5 copay Generic: $5 copay Generic: $0 copay
Brand: $10 copay Brand: $10 copay Brand: $20 copay
Non-formulary: $10 copay5 Non-formulary: Non-formulary: $50 copay
$35 copay
1 If you enroll in an HMO plan, you can obtain services only within the plan’s geographic service area, except for urgent and emergency services.
2 The Emergency Room Copay does apply if you are admitted for observation but are not admitted as an inpatient.
3 Preventive care is 100% covered in-network with no deductible required. Routine tests and screenings are free to you when you use in-network providers, too.
4 Some contraceptive prescriptions for women are 100% covered in-network with no copay or deductible required. Age limits may apply. Contact the plan for details.
5 For Kaiser plans, non-formulary brand-name drugs are not listed on the drug formulary and aren't covered unless approved through an exception process initiated
by the members plan physician. If approved, non-preferred (non formulary) brand-name drugs are covered at the brand copay.
6 Diabetic medications are available in 90 day supplies at select retail pharmacies.
If you don’t enroll for coverage when you’re first eligible, you’ll be automatically enrolled in the TALB default coverage for yourself only: Aetna Choice POS II medical plan, Delta
PPO Plus Premier plan, vision coverage, life and accidental death & dismemberment insurance, and the employee assistance program.
13Prescription Drug Benefits
Reimbursement for Each of our medical plans has a three-tiered prescription drug benefit. With this type of plan,
Hearing Aids the amount you pay for prescriptions depends on:
Active employees who are insured •• The type of drug you choose;
in one of the District’s medical •• W
hether the drug is a generic or brand, part of your plan’s drug formulary (a list of drugs the
plans may request reimbursement insurance company considers “preferred choices” based on their effectiveness and cost), or
from the District for the costs not (non-formulary); and
of hearing aids. The maximum
amount of reimbursement shall •• Whether you fill your prescription at a retail pharmacy or through the mail-order program.
be $1,000 within any three-year Generally:
period. The cost of hardware,
fitting tests, and other tests related •• Generic drugs are in the plan’s first tier and are your lowest copay option;
to the hearing aids is included •• B
rand-name drugs that are on your plan’s drug formulary are in the second tier for most
for reimbursement purposes. plans, and are your mid-range copay option; and
Dependents covered by District •• B
rand-name drugs that are not on your plan’s drug formulary (non-formulary) are in
medical plans are not eligible for the third tier for some plans, or may not be covered under certain plans; if they’re covered
this benefit. under your plan, these are generally your highest copay option.
To obtain a reimbursement form,
visit our LBUSD Benefit website at Generic drugs are the cheaper equivalent of many brand-name drugs. In fact, they have
www.lbusdwellness.com. to prove that they’re just as effective as the brand-name drug before they’re approved. In
addition, many brand-name drugs that aren’t on the formulary have similar equivalents that
are. So if your doctor prescribes a drug that’s not on the formulary, ask whether a generic or
formulary brand drug would work just as well.
Prescription
Drug Costs Using the Mail-Order Pharmacy
Keep in mind, prescription If you’re taking a medication on an ongoing basis for a chronic condition such as diabetes or
drug copays accrue towards heart disease, you may want to consider using your plan’s prescription drug mail-order service.
the out-of-pocket maximum
The mail-order service usually saves you money, because you can order a larger supply of your
for all medical plans. Note
medication for the same copay. When you use the mail-order pharmacy, you generally receive
there is a separate prescription
drug out-of-pocket maximum about a three-month supply of the medication.
for the Choice POS II plan.
($5,550 individual/$11,100 Prior Authorization and Specialty Drugs
family, in-network only)
Depending on your pharmacy plan, you may be required to receive prior authorization before
you can fill prescriptions for certain drugs. In addition, you may need to use a Specialty
Pharmacy designated by your plan to fill prescriptions for certain drugs. For more information,
contact your plan’s member services or visit the plan’s website.
SafeGuard RX Diabetes Care Value Program
Express Scripts works to help reduce the costs of medicine commonly used to treat diabetes.
If you use diabetes-related prescription drugs and are enrolled in the Choice POS II (Open
Access) plan, you will need to fill your prescriptions through a new network of pharmacies
in the Diabetes Care Value Program. These pharmacies help to control costs by giving
you 3-month supplies of diabetes medicine with each refill. The network includes select
pharmacies near you or delivery from the Express Scripts Pharmacies network. For more
information, call (866) 662-0297 or go to www.express-scripts.com.
14 14Advanced Utilization Step Therapy Program
Step Therapy is a program designed exclusively for employees who have certain
conditions—arthritis, high blood pressure and high cholesterol, for example—that
require them to take medications regularly. Your Prescription Drug
Benefits
In Step Therapy, medications are grouped in categories, based on cost:
Your prescription drug
•• Front-line medications — the first step — are generic medications proven safe,
benefits depend on your
effective and affordable. These medications should be tried first because they can
provide the same health benefit as more expensive medications, at a lower cost. medical plan. You can find
more details on the following
•• Back-up medications — Step 2 and Step 3 medications — are brand-name
medications such as those you see advertised on TV. There are lower-cost brand pages:
medications (Step 2) and higher-cost brand medications (Step 3). Back-up medications • CSEA: page 11
always cost more than front-line medications. • Non-Represented:
page 12
HOW IT WORKS • TALB: page 13
When your doctor writes you a prescription: Keep in mind that to receive
•• Ask your doctor if a generic medication — listed by your plan as a front-line those benefits, you’ll need to
medication — is right for you. use a pharmacy that’s part of
•• If you’ve already tried a front-line medication, or your doctor decides one of these your plan’s network.
medications isn’t appropriate for you, then your doctor can prescribe a back-up
medication. Ask your doctor if one of the lower-cost brands (Step 2 medications) listed
by your plan is appropriate.
•• You can get a higher-cost brand-name medication at a higher copay if the front-line or
Step 2 back-up medications aren’t right for you.
For more information, call (888) 290-6620 or go to www.aetna.com if you are enrolled
in the HMO or HDHP plan. If you are enrolled in the Aetna Choice POSII plan call
(866) 662-0297 or go to www.express-scripts.com.
A Special Note about Express Scripts
Your prescription drug coverage is provided through Express Scripts if you select the
Aetna Choice POSII plan.
If you participate in any of the other medical plans, your prescription drug coverage is
provided through your medical plan.
If your prescription drug coverage is provided through Express Scripts, you’ll receive a
separate ID card for prescription drug coverage. You should be prepared to present your
Express Scripts ID card whenever you have a prescription filled at a retail pharmacy. If
you don’t, you may be denied benefits and have to pay for your prescription up front.
To receive benefits, you must fill your prescription by using either the mail-order pharmacy
or a participating retail pharmacy. To find a participating pharmacy, you can call Express
Scripts Member Services at (866) 662-0297 or visit www.express-scripts.com.
The Specialty Pharmacy
Certain drugs covered by the Express Scripts plan require you to purchase them through
Accredo, Express Scripts' Specialty Pharmacy program. These drugs include growth
hormone medications as well as drugs to treat cystic fibrosis, multiple sclerosis, and viral
hepatitis. These drugs may be dispensed through mail-order only. For more information
or to enroll in the Specialty Pharmacy program, call Express Scripts Member Services
(866) 662-0297.
15
15Clinical Prior Authorization
With the Express Scripts plan, certain prescriptions require approval from the plan,
or “clinical prior authorization,” before they’ll be covered. These include, but aren’t
limited to, biological response modifiers and anti-obesity, insomnia, and migraine
medications. To request approval, you, your pharmacy, or your physician should call
(866) 662-0297. When you call, you’ll need to have the name of the medication,
your physician’s name and phone number, and your member ID and group number
(which are printed on your Express Scripts ID card).
Is Your Drug on the Formulary?
If you're enrolled in the Aetna Choice POS II plan, you can contact
Express Scripts Member Services, (866) 662-0297, or visit the Express
Scripts website, www.express-scripts.com, for information about which
drugs are on the national preferred formulary. Keep in mind that your
benefits will be highest if you receive a generic drug.
Employee Assistance Program (EASE)
EASE is an additional benefit and specialized program provided by Employee
Assistance Service for Education (EASE), which is part of the Los Angeles County
Office of Education. EASE is available to you and your immediate family members.
EASE provides professional and confidential counseling to help you with:
•• Family troubles with spouse or children; •• Grief, loss, and transitions;
•• Emotional distress; •• Legal or financial referrals; and
•• Drug or alcohol abuse; •• Worksite and phone consultations.
•• On-the-job anxieties and stress;
Access to all of the EASE services is just a phone call away — (800) 882-1341.
16 16Dental Plan Options
Because regular dental care is vital to your overall health well being, your dental benefits are an important part of your health care
package.
With the DeltaCare DHMO plan, you must receive care from a provider in the plan’s network or no benefits will be paid. For the Delta
PPO Plus Premier plan, you have the flexibility to receive care from any provider; however, you may pay less if you receive care from a
Delta Dental contracted provider, because Delta Dental negotiates lower fees for Delta plan members.
The chart below summarizes the main features of the dental plans available to all District employees. For the full details of each plan,
including exclusions, refer to the Evidence of Coverage (EOC) plan documents.
MAJOR COVERAGE Delta PPO Plus Premier Plan DeltaCare DHMO Plan
Eligibility Employee only; dependent coverage at
Employee and dependents
employee’s expense
Choice of Dentist For highest level of benefits, you must use
You must use a dentist on the panel of
In-Network dentists. Enrollees also have the
primary care dentists
flexibility to see any licensed dentist
Delta Dental Any Licensed non-PPO
PPO Dentist Out-of-Network Dentist
Covered Fees Contracted fees U&C1 All services provided by contract
Annual Maximum $2,200 $2,000 No maximum
Deductible None None
What the plan pays:
• Pays 70% – 1st year of participation
• Pays 80% – 2nd year of participation Per copay schedule shown in the EOC available on
Coinsurance/Copay • Pays 90% – 3rd year of participation our Benefit website at www.lbusdwellness.com.
• Pays 100% thereafter and the LBUSD website at www.lbschools.net
Levels increase each year if employee visits
dentist at least once a year
Preventive Services
Teeth Cleaning Covered – 2 per year Covered in full – 2 per year
Full Mouth X-rays Covered – every 5 years Covered in full – every 2 years
Covered – 2 per year to age 18;
Bite-Wing X-rays Covered in full – 2 per year
1 per year ages 18 and up
Fluoride Treatments Covered – 2 per year2 Covered in full – to age 18
Therapeutic Services
Extractions Covered2 Covered in full (uncomplicated)
Fillings Covered2 Covered in full (amalgam, acrylic)
Root Canals/Periodontics Covered2 Covered subject to copay
Crowns, Dentures, Bridges
Crown Covered2 Covered subject to copay
Denture/Bridge Paid at 50% Covered subject to copay
Orthodontia
Children/Adults Not covered Covered subject to $350 start-up fee, $1,200 copay
1 If a covered individual uses a Delta PPO Plus Premier dentist, reimbursement under the plan is based on the plan’s allowed fees. All other dentists
are subject to reimbursements based on the usual & customary (U&C) amount for the service.
2 Covered at applicable coinsurance level.
17
17Vision Coverage
With the Medical Eye Services (MES) vision plan, you have coverage for a wide range of vision services. Vision coverage is available to
employees only.
After you’ve met the annual deductible, the plan begins to pay benefits. The amount the plan pays depends on whether or not you
visit a participating provider. When you go to a participating provider, the plan provides full coverage for many covered services and
materials. When you go to a non-participating provider, charges will be paid on the basis of prevailing fees, but not to exceed the
schedule of allowances in the right column of the following chart.
For a complete list of covered services and limitations/exclusions, refer to the Benefits Summary, available on our LBUSD Benefit website
at www.lbusdwellness.com.
MAJOR COVERAGE Participating Provider Non-participating Provider
First, you pay an annual deductible …
Annual deductible $10
Then, the plan pays for the following benefits …
Exams
Ophthalmic Examination
(with or without refraction, once every Plan pays $60
12 months)
Plan pays 100%
Optometric Examination
(with or without refraction, once every Plan pays $50
12 months)
Frames
Two every 24 months Plan pays 100%1 Plan pays $40/frame
Lenses (per pair, up to two pairs every 24 months)
Single Vision (plastic) Plan pays $43
Bifocal (plastic) Plan pays $60
Trifocal (plastic) Plan pays $75
Aphakic Monofocal Plan pays $120
Aphakic Multifocal Plan pays 100% for two pairs of standard lenses2 Plan pays $200
Tints (Pink or Rose #1 or #2)
Single vision Plan pays $10
Bifocals Plan pays $15
Trifocals Plan pays $20
Tints (other than Pink or Rose #1 or #2) Not covered Not covered
Contact Lenses (in lieu of frames and lenses, once every 24 months)
Medically Necessary Plan pays 100%3 Plan pays $250
Cosmetic Plan pays 100%, up to a $100 maximum Plan pays $100
1 A standard frame is any frame that has a retail value of $60 or less; you are responsible for any charges above $60.
2 Standard lenses are plastic and fit any frame with an eye size less than 56 mm.
3C ontact lenses are medically necessary if they are prescribed following cataract surgery, when they are the only means to correct visual acuity to
20/70 in the better eye, or when necessitated by anisometropia or certain conditions of keratoconus. Prior authorization from Medical
Eye Services is required before contact lenses will be considered medically necessary.
18 18Flexible Spending Accounts (FSAs)
The District gives all eligible employees access to two flexible spending accounts (FSAs) — a Health Care
FSA and a Dependent Care FSA. Non-represented employees who enroll in the Choice POS II (Open Access)
HDHP will have access to the Limited Purpose FSA. These accounts let you pay for certain expenses using
pre-tax contributions — that means less of your paycheck goes to taxes and you take home more money!
The FSAs are administered by WageWorks.
FSAs are now on the plan year and are effective from July 2018 through June 2019. Enrollment for
FSA participation will take place in April.
FSAs, HSAs, When you take advantage of the FSAs, you can:
and Your
•• Put more money in your pocket;
Domestic
Partner •• Reduce your income tax liability;
You can use the •• Budget for non-covered health care expenses; and
funds in your Health •• Set aside dollars for day care and other dependent care costs — so you have the money when you need it.
Care FSA and Choice
With FSAs, you can also save for expected out-of-pocket costs, such as:
POS II HDHP HSA
to pay for expenses •• Health care expenses — vision exams and eyeglasses, hearing aids, orthodontia, medical and dental
for your eligible deductibles, even laser vision surgery and other services not covered by your medical benefits plan; and
dependents. However, •• Work-related dependent care expenses — nursery schools and day care centers for your children, or for
because of IRS an adult dependent.
regulations, your
California-registered More information about eligible expenses is available on our LBUSD Benefit website at www.lbusdwellness.com.
domestic partner is When you enroll in an FSA, you elect how much money you want to contribute for the calendar year. The
not considered an District then takes that amount out of your paychecks in equal installments — before taxes are taken out.
eligible dependent for You can then submit a claim for reimbursement from these accounts whenever you have eligible expenses.
purposes of However, it’s important to budget carefully, because any money that’s left over at the end of the year will be
the FSA or HSA unless forfeited. And keep in mind that once you’ve elected a contribution amount, you’re not allowed to change
he or she is an IRS tax it during the year unless you have a qualifying status change (although not all status changes allow you to
dependent. Also, you change your contribution amount).
cannot spend funds
from your Dependent 2018 FSA Contribution Limits
Care FSA on the
For 2018, you can contribute the following amounts to your FSA:
children of your
domestic partner, •• Health Care FSA: $2,650
unless the children
•• Limited Purpose FSA: $2,650
qualify as your IRS tax
dependents. •• D
ependent Care FSA: $5,000 (if you are single or married and filing taxes jointly) or $2,500 (if you are
married and filing taxes separately)
Note: Enrollment for FSAs is now concurrent with the regular plan year, July 2018-June 2019.
Contribution amounts may change each year, based on IRS regulations, and will be communicated during
the enrollment period in the fall. If you don’t use your whole balance by the end of June 2019, you’ll have a
grace period to use the funds and submit claims. If you don’t use your balance by September 15, 2019
and submit claims by September 28, 2019 you’ll forfeit any remaining funds.
Limited Purpose FSA — for Non-Represented Employees Enrolled in the Choice POS II
(Open Access) HDHP
If you enroll in the CPOSII HDHP, you cannot enroll in the regular Health Care Flexible Spending
Account (FSA). However, you can enroll in a Limited Purpose FSA. You can only use a Limited Purpose
FSA to pay certain non-medical expenses, such as eligible dental or vision care.
Important! If you currently participate in an FSA and want to enroll in the CPOSII HDHP for 2018 – 2019, IRS
regulations require that you use up your FSA balance before contributing. If you have no balance ($0.00) in
your FSA on June 30 2018, you can contribute to the HSA beginning July 1, 2018. If you don't use your
full FSA balance by June 30, 2018, you won't be eligible to open an HSA until July 1, 2019.
19
19Group Life Insurance and Group
Accidental Death & Dismemberment
Insurance
If you’re eligible, the District automatically provides you with group life and basic AD&D
insurance:
•• Group life insurance pays a benefit to your beneficiary in the event of your death.
•• Group basic AD&D insurance provides an additional benefit if you die as the result of an
accident. It also provides a benefit if you have certain injuries as the result of an accident
— the benefit you receive is a percentage of the total benefit, depending on the extent
of your injury.
Your coverage level is shown in the chart below.
Employee Group Level of Coverage
• Life insurance benefit equal to one times annual
Bargaining and Non- salary, but not less that $15,000 or more than
bargaining Unit $50,000.
Employees
• AD&D coverage is provided in the same amount.
Management,
Supervisory, • Life insurance benefit of $50,000.
and Confidential • AD&D coverage is provided in the same amount.
Employees
Life Insurance Conversion
Your life insurance coverage will terminate at the end of the month in which you are no
longer eligible for District benefits. However, you may be eligible to convert to an individual
life insurance policy at that time. For more information, please call the life insurance carrier,
Reliance Standard, at (800) 644-1103.
20 20Retirement Plans
In addition to your pension benefits, the District is pleased to offer you two additional
plans to help you save for retirement.
The District offers 403(b) and 457 plans in accordance with the Internal Revenue Code to
allow participants to save for retirement with pre-tax dollars. These plans offer the following
benefits:
•• Contributions are made on a salary-reduction basis;
•• Variety of investment choices; and
•• Easy payroll deduction.
Under current law, before age 59½, a 10% federal tax penalty may apply to amounts
distributed from your plan (and certain deemed distributions) which are attributable to an
IRA or another qualified plan. Withdrawals are subject to ordinary income tax.
For more information on your District retirement plans, please call the plan contacts.
Plan Plan Contact Phone Number
403(b) SchoolsFirst FCU (800) 462-8328 x4116
457 Morgan Stanley (562) 901-4378 (Barbara Fleming)
Internal Revenue Code (IRC) Section
125 Flexible Fringe Benefits Plan
The Long Beach Unified School District is pleased to provide our IRC Section 125
Flexible Fringe Benefits plan. This plan will be available for all employees, including the
Long Beach Unified School District’s Board of Education and Personnel Commission,
Teachers Association of Long Beach, California Schools Employee Association Chapter #2,
Management, Supervisors, and Confidential and Non-represented Employees.
If you pay premiums for certain District benefits, the Section 125 plan allows you to reduce
your taxes by paying certain qualified expenses through payroll deductions on a pre-tax
basis (for example, if you pay premiums for Delta Dental coverage for your dependents, or
you’re a job-share employee who pays medical premiums). By participating in a Section 125
plan, you will lower your taxable income, which can result in lower federal and state taxes.
If you pay premiums for your eligible benefits, you’ll have the option to enroll in the
Section 125 plan.
21
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